EDITORIAL

Minimizing risk

Public concern about adolescent violence and other risky behaviors of young people has led to attempts to correlate such behaviors with how children and the people around them lead their lives. One of the most recent and comprehensive efforts was the National Longitudinal Study of Adolescent Health, funded by Congress.* Not surprisingly, this extensive nationwide study found that there appear to be personal and family correlates with violent behavior, suicide, early sexual experiences, and poor communication between adolescents and their parents. Factors that protect children from risky adolescent behavior also are identifiable. Some of these factors include the following:

• Being connected to parents and family, school, and other adults; attaining a high grade-point average; and feeling part of a religious community protect from attempting suicide.

• Being female, Native American, or Hispanic; abusing substances; being a victim of violence; having a friend or family member who recently attempted suicide; and having easy access to firearms are risk factors for attempting suicide.

• Perceiving that parents and family disapprove of adolescent sex, having a religious identity, maintaining a high grade-point average, and taking a pledge of virginity correlate with a delay in sexual activity.

• Eating dinner with the family at least five times a week is associated with a reduction in substance use, delinquent behavior, and early sexual intercourse. Such regular meal sharing is one measure of consistency within a family.

These findings raise as many questions as they answer. What is it about connection to religion that protects adolescents? Is it the admonition to do good, the spirituality, or the feeling of being part of a concerned community? Is it necessary that the shared family activity be the evening meal, or are other regular family activities just as likely to protect from risky behavior? Probably most important for pediatricians, these findings support the advice we give to parents. Families are important, and so are the traditions, consistency, and standards that they provide under the best of circumstances. Rules are important, too, and a child whose family's rules are well articulated, consistent, and accepted by all is less likely to get into trouble.

Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics, is Vice Chair, Pediatric Education, and Director, Residency Training, Johns Hopkins University School of Medicine, Baltimore.

*Institute for Youth Development: Protecting adolescents from risk: Transcript of a Capitol Hill briefing on new findings from the National Longitudinal Study of Adolescent Health (Add Health), June 3, 1999

 

Julia McMillan, ed. Julia McMillan. Editorial: Minimizing risk. Contemporary Pediatrics 2000;8:9.